Abstract
This paper aims to explore smokefree prison policy, from the perspective of people in custody in Scotland. In total, 77 people in custody in Scotland were interviewed in the period leading up to implementation of a nationwide prison smokefree policy. Data were thematically analysed to identify the diversity of views and experiences. Participants described a widespread awareness in prisons of plans to implement a smokefree policy from 30 November 2018. Opinions about smokefree prisons varied among participants based on perceptions of the fairness, and anticipated positive and negative consequences of removing tobacco from prisons. At the time of the interviews, people in custody were responding to the impending smokefree policy, either by proactively preparing for the smokefree rule change or by deploying avoidance strategies. Participants described opportunities and challenges for implementing smokefree policy in prisons across three main themes: the role of smoking in prison, prison smoking cessation services and motivations for quitting smoking among people in custody. This study exploring smokefree prisons from the perspectives of people in custody has several novel features which extend the evidence base. The findings highlight measures for jurisdictions to consider when planning to prohibit smoking in their prisons in the future. These include the need for evidence-based smoking cessation support in advance of smokefree policy, effective communication campaigns, consideration of broader structural determinants of health in prison and ongoing measures to reduce rates of return to smoking post release.
Highlights
Smoking is a leading cause of preventable illness and death globally (Reitsma et al, 2017)
As illustrated in the quote below, interviews were conducted at a time where there was reportedly widespread awareness among people in custody that a comprehensive smokefree policy would be implemented in Scottish prisons in 6–12 months’ time: WP5.A08.Smoker: “[. . .] every prisoner got a letter saying [. . .] as of November 2018, there’ll be a smoking ban coming [. . .] there’s a poster [. . .] it was like, nine months go to, eight months to go, seven months to go
This study exploring perspectives of smokefree prison policy in people in custody in Scotland contributes to the evidence base available to help inform jurisdictions that are considering removing tobacco from their prisons in the future
Summary
Smoking is a leading cause of preventable illness and death globally (Reitsma et al, 2017). While there have been significant reductions in smoking at a population level, people in custody (prisoners who have been convicted or on remand awaiting trial) are one group among whom tobacco use has been very high (Spaulding et al, 2018). Interventions providing (free) behavioural support and/or nicotine replacement therapy (NRT) to people in custody who smoke is one potential way in which countries may support smoking cessation in prison. A review evaluating the effectiveness of smoking cessation interventions in prisons, which included ten quantitative studies of varying methodological quality, found evidence that smoking cessation interventions “can significantly increase the likelihood of quitting in prison and increase abstinence post release”
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